Psychiatric registration is an outdated legal concept meaning regular monitoring of a patient, monitoring his condition in outpatient psychiatric institutions ( neuropsychiatric dispensaries , dispensaries and psychiatric rooms); however, the very fact of such an observation often led to social constraints.
Psychiatric registration was introduced in the USSR by order of the USSR Ministry of Health dated February 11, 1964 No. 60 "On the mandatory registration of patients with a diagnosis of mental illness for the first time in their life." From this moment on, any appeal to a psychiatrist associated with the issuing of a psychiatric diagnosis to a citizen automatically led to registration with a psychiatric register with associated social restrictions [1] .
Registered persons were required to regularly appear in the dispensary; however, the ability to "deregister" was almost absent [2] . There was a practice of universal “registration” of all persons with mental disorders who fell into the field of vision of a psychiatrist, regardless of their desire [1] [3] . The percentage of registered Soviet citizens increased over time [4] . According to data published in 2007, by 1987, 10 million people in the USSR were registered in neuropsychiatric dispensaries [5] .
The fact of being registered often led to social restrictions [4] [6] [7] and lifelong stigma [4] . Compared with other citizens, it was more difficult for a registered person to get housing [4] and get a job [4] [6] ; people with psychiatric diagnoses often lost the opportunity to study at universities [8] ; they could not get a driver’s license, go to a sanatorium, exchange an apartment, etc. Any organization could contact the dispensary with a request about whether a person is registered in a psychiatric office, and in case of a positive answer, the person was discriminated against [9] . In particular, there was the concept of “inappropriateness of correspondence”: neuropsychiatric dispensaries, in violation of all the rules of medical ethics, reported without any restrictions that a citizen was registered in the dispensary and, therefore, correspondence with him in response to his complaints was inappropriate [10] .
In the early 1990s, the concept of “psychiatric registration” in the Russian Federation was officially abolished. So, the Law of the Russian Federation “On psychiatric care and guarantees of the rights of citizens in its provision” , enacted from January 1, 1993, does not provide for psychiatric registration [1] . By order of the Ministry of Health of the Russian Federation dated January 11, 1993 No. 6 “On Certain Issues of the Activities of the Psychiatric Service”, the order of the USSR Ministry of Health “On Mandatory Accounting ...” was declared not to be applied in the Russian Federation [11] . The tasks of outpatient psychiatric institutions have been determined by the advisory and therapeutic psychiatric care to the population and the follow-up of patients [1] .
Thus, instead of the concept of “psychiatric registration” in the early 1990s, the concepts of “counseling and treatment assistance” and “dispensary observation” were officially introduced in the Russian Federation. Accordingly, a group of "consultative and medical care" and a group of "dispensary observation" were allocated. Outpatient cards of patients of the respective groups were indicated on the covers in large letters "K" and "D" [12] .
According to the "Law on Psychiatric Care ...", outpatient psychiatric care is provided (with the exception of dispensary monitoring) when a person suffering from a mental disorder volunteers (Article 26, paragraph 2) [13] . According to the legislation, patients of the consultative-treatment group visit a neuropsychiatric dispensary only on their own, and if they do not seek help for a year, their cards are submitted to the archive [12] .
The concept of dispensary observation differs from the Soviet concept of psychiatric registration in that we are talking only about patients who need dispensary monitoring at this time (psychiatric registration was actually life-long) [9] . Clinical observation, according to the "Law on Psychiatric Care ...", "can be established for a person suffering from chronic and protracted mental disorder with severe persistent or often exacerbating painful manifestations." It is established “regardless of the consent of the person suffering from a mental disorder or his legal representative <...> and involves monitoring the state of mental health of a person through regular examinations by a psychiatrist and providing him with the necessary medical and social assistance” (Article 26, paragraph 3). The commission of psychiatrists decides on the establishment or termination of dispensary observation; dispensary observation ceases upon recovery or with a significant and lasting improvement in the mental health of the person [13] . In the event of termination of the follow-up, the medical history (“card”) is stored in the registry, and a person always has the right to seek medical advice [9] .
A person suffering from a mental disorder cannot refuse dispensary observation established for him, however, within the meaning of subsection 11 (4) of the Law on Psychiatric Care ... such a person has the right to refuse treatment prescribed or provided to him as part of a dispensary observation [1] . Dispensary observation entails certain restrictions for persons with mental disorders and may cause a refusal to issue a permit to carry weapons and / or to issue a driver’s license [14] .
Although the concept of “psychiatric registration” continues to be used in some newly adopted legislative acts, in reality this concept should not be used in outpatient psychiatric institutions in Russia. Requests for certificates confirming whether or not a citizen is registered with a psychiatric institution are meaningless and illegal, as is the issuance of certificates indicating: “not registered” [1] .
According to the Law on Psychiatric Care ..., no organization and no person has the right to write requests about whether a person is being observed at the dispensary, and psychiatric institutions have no right to respond to such requests. Only court and investigation bodies , as well as medical institutions, are entitled to ask about this if information about this must be obtained for proper treatment or examination. Other organizations can only make a request whether a citizen can do this or that job due to his health condition, and the dispensary answers this question (“yes” or “no”), regardless of whether this citizen was observed in the dispensary, and does not provide no information about the diagnosis, which, as indicated in Article 9 of the Law, is included in the concept of “medical secret” [9] .
The use of the concept of “advisory accounting” by some Russian medical institutions is also unreasonable, for example, in certificates stating that a person “is on advisory accounting”. The phrase “advisory accounting” has no legal meaning, and the content of such a certificate contradicts the provisions of the “Law on psychiatric care ...”. Meanwhile, officials receiving an answer about a citizen being registered for consultancy come to the incorrect conclusion that a person is under medical supervision with all the negative social and legal consequences that follow from this [1] .
Conducting an advisory “record” of patients without their knowledge and consent, in the absence of the procedure for setting up such a “record” prescribed by law or other regulatory legal acts , can lead to serious violations of citizens' rights [1] .
See also
- Involuntary hospitalization in psychiatry
- Psychiatric hospital
- Discrimination of persons with mental disorders
- Abuses and medical errors in psychiatry
Notes
- ↑ 1 2 3 4 5 6 7 8 Argunova Yu.N. Rights of citizens in the provision of psychiatric care (Questions and Answers). - Moscow: Griffin, 2014 .-- 640 p. - 1600 copies. - ISBN 978-5-98862-190-4 .
- ↑ Van Voren R. On dissidents and insanity: from the Soviet Union, Leonid Brezhnev to the Soviet Union, Vladimir Putin / Per. from English K. Muzhanovsky; foreword I. Martsenkovsky. - Kiev: Publishing House of Dmitry Burago, 2012 .-- 332 p. - ISBN 978-966-489-158-2 .
- ↑ Pervomaisky V. Presumption in Psychiatry // News of the Psychiatric Society of Ukraine. - 1995. - No. 2 . - S. 7-17 .
- ↑ 1 2 3 4 5 Van Voren R. Psychiatry as a tool for coercion in post-Soviet countries. - European Union, 2013 .-- 26 p. - ISBN 978-92-823-4595-5 . - DOI : 10.2861 / 28281 .
- ↑ Ougrin D, Gluzman S, Dratcu L. Psychiatry in post-communist Ukraine: dismantling the past, paving the way for the future // The Psychiatrist. - February 16, 2007.
- ↑ 1 2 Report of the US Delegation to assess recent changes in Soviet psychiatry // Schizophr Bull. - 1989.- T. 15, suppl. 1 , No. 4 . - S. 1-219 . - PMID 2638045 . In Russian: Report of the US Delegation on Assessing Recent Changes in Soviet Psychiatry
- ↑ Vasilenko N. Yu. “Fundamentals of Social Medicine”, textbook , Vladivostok: Far Eastern University, 2004. P. 33—34.
- ↑ Fedorov G. Psychiatry in Russia: a slow forward movement (English) // BBC.
- ↑ 1 2 3 4 Rotshtein V.G., Bogdan M.N., with the participation of Dolgov S.A., Klipinina N.V. and Hain A.E. Fundamentals of Psychiatric Literacy: A Toolkit for Educators . - Moscow: Community Initiatives in Psychiatry. Charity Fund “Quality of Life”, 2008. - 92 p.
- ↑ Queen L.V. Power and Soviet dissidentism: results and lessons. Part 1 (rus.) // Electronic journal "Polemics": magazine. - No. 11 . Archived on April 22, 2008.
- ↑ Order of the Ministry of Health of the Russian Federation dated January 11, 1993 No. 6 “On some issues of the activity of the psychiatric service” Archived on June 21, 2018.
- ↑ 1 2 Kozlovsky V.M. From the report on the practical work of the local PND psychiatrist No. 4 of Moscow for 1993-1996. // Independent Psychiatric Journal. - 1997. - No. 4. - S. 52-59.
- ↑ 1 2 Law of the Russian Federation of July 2, 1992 N 3185-I “On psychiatric care and guarantees of the rights of citizens in its provision” (as amended and supplemented) .
- ↑ Clinical Psychiatry. Selected Lectures: Textbook / Ed. L. M. Bardenstein, B. N. Pivnya, V. A. Molodetsky. - M .: INFRA-M, 2014. - 432 p. - (Higher education). - ISBN 978-5-16-006541-0 . - ISBN 978-5-16-100217-9 . - DOI : 10.12737 / 861 .